title: [Bacteraemia at a second level hospital: epidemiological study, analysis of pronostic factors associated to mortality and economic cost estimation].
abstract: BACKGROUND
  Bacteraemia (B) accounts for a considerable proportion (0.36%) of all hospital admissions due to infections diseases and it is associated to increased hospital costs. The aim of this study is to describe a cohort of patients with bacteraemia at a second level hospital, to analyze factors associated to mortality and its economical impact during hospital admission.
  
  
  METHODS
  Observational study of a cohort of adult patients with bacteraemia admitted at a second level hospital during 2010. Data collection from clinical records has been done according to a standard protocol: epidemiological and clinical variables and factors associated to mortality were analysed. Total economical cost per patient was estimated.
  
  
  RESULTS
  148 patients were included: 80 community B (55.4%), 23 health care associated B (15.5%) and 45 nosocomial B (28.5%). The incidence was 9 cases 10.000 persons/year. Mean age was 69 years and the global mortality was 24%. In bivariate analysis smoking, diabetes mellitus, McCabe Jackson score type I-II, Pitt Index ≥ 3, APACHE ≥ 20, Glasgow ≤ 9, shock, respiratory distress, invasive procedures, nosocomial bacteraemia and inadequate empiric or definitive antibiotic treatment were associated to mortality (p<0.05). Factors associated to mortality in multivariate analysis included McCabe Jackson score type I-II (OR 4.95; 95% CI 1.095-22.38), haemodialysis during acute stage (OR 7.8; 95% CI 2.214-27.773) and inadequate empiric antibiotic treatment (OR 7.68; 95% CI 19.82-29.77). Admission economic cost per patient was 9,459 € for community acquired bacteriemia, 5,656 € for health care associated bacteraemia and 41,680€ for nosocomial bacteraemia.
  
  
  CONCLUSIONS
  Comorbidity, inadequate empiric antibiotic treatment and haemodialysis during acute phase are statistically significantly in our cohort of patients with bacteraemia.
authors.affiliation: Servicio de Medicina Interna, Hospital Universitario Rafael Méndez, Murcia, Spain. josejoaquinhdezroca@gmail.com
authors.forename: José Joaquín
authors.initials: JJ
authors.lastname: Hernández-Roca
authors.forename: Elisa
authors.initials: E
authors.lastname: García-Vázquez
authors.forename: Alicia
authors.initials: A
authors.lastname: Hernández
authors.forename: Manuel
authors.initials: M
authors.lastname: Canteras
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Herrero
authors.forename: Eva
authors.initials: E
authors.lastname: Cascales
authors.forename: Enrique
authors.initials: E
authors.lastname: Mené-Fenor
authors.forename: Joaquín
authors.initials: J
authors.lastname: Gómez-Gómez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000191:economics / Q000382:microbiology* / Q000401:mortality*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D015897:Comorbidity; D003365:Costs and Cost Analysis; D003422:Critical Care / Q000191:economics / Q000706:statistics & numerical data; D003428:Cross Infection / Q000191:economics / Q000382:microbiology* / Q000401:mortality*; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000191:economics / Q000382:microbiology / Q000401:mortality; D016908:Gram-Positive Bacterial Infections / Q000191:economics / Q000382:microbiology / Q000401:mortality; D017048:Health Care Costs; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents